NPIMap

Organization Active NPI

Memphis Pediatrics PLLC

  • Pediatrics Physician
  • Germantown, TN
National Provider Identifier
1942415245
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD28107 Issued in TN
Legal business name
MEMPHIS PEDIATRICS PLLC
Practice address
1255 South Germantown Road
Germantown, TN 38138
Phone
(901) 432-1591
Fax
(901) 432-1596
NPI assigned
May 11, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Cheryl W Mitchell
Title
Billing Manager
Phone
(901) 432-1591

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD17825 TN
Pediatrics Physician 208000000X MD18312 TN
Pediatrics Physician 208000000X MD28107 TN Primary

Addresses

Primary practice location

1255 South Germantown Road
Germantown, TN 38138

Mailing address

PO Box 1798
Dept 07-003
Memphis, TN 38119
Phone (901) 432-1591

National Provider Directory

National Provider Directory

Locations

1255 S Germantown Rd
Germantown, TN 38138
Phone (901) 432-1591

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942415245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1798",
            "address_2": "DEPT 07-003",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-432-1591",
            "fax_number": "901-432-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 SOUTH GERMANTOWN ROAD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-432-1591",
            "fax_number": "901-432-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "901-432-1591",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD17825",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD18312",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD28107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.